Prognostic value of mean platelet volume in patients undergoing elective percutaneous coronary intervention

Objective: We sought to determine the role of mean platelet volume (MPV) for predicting long-term outcomes of elective percutaneous coronary intervention (PCI). Methods: On the basis of retrospective cohort study, we collected characteristics of 680 patients undergoing elective PCI from October 2005 to August 2010. The patients who had preoperative MPV were assessed for developing major adverse cardiac events (MACE) during 1-year follow- up. They were categorized into two groups including MPV <9.6 fL (n=89) and MPV �9.6 fL (n=92). Data were analyzed using t-test, chi-square test, Pearson correlation, receiver operating characteristic (ROC) curve and logistic regression. Results: One-hundred eighty one patients (26.6) met inclusion criteria. The MACE was observed in 29 patients (16); and its rate in low- and high-MPV groups was 11.2 and 20.7, respectively (p=0.084). MPV was significantly higher in the patients with left ventricular ejection fraction (LVEF) <40 compared with that of �40 (p<0.001). There were a significant and negative correlation between MPV and platelet count (r=-0.305, p<0.001), and significant and positive correlations between MPV and platelet distribution width (PDW) and platelet large cell ratio (P-LCR) (r=0.615, p<0.001 and r=0.913, p<0.001; respectively). The best MPV cut-off point was 9.25 fL; the sensitivity and specificity were 79 and 38, respectively. Elevated MPV was the best predictor of MACE at 1-year follow-up (OR=11.359, 95 CI 2.481-51.994, p=0.002). Conclusion: The results indicate that preoperative MPV is an independent predictor of the MACE at 1-year follow-up in the patients undergoing elective PCI. Moreover, it may be useful for risk stratification in such cases. © 2015 by Turkish Society of Cardiology

Acute pulmonary embolism caused by enlarged uterine leiomyoma: A rare presentation

Objective: Management of emergency care. Background: Deep venous thrombosis (DVT) and subsequent pulmonary embolism (PE) caused by pelvic vein compression are rare and life-threatening complications of leiomyoma of the uterus. Case Report: We report a 42-year-old virgin woman with a history of leiomyoma who presented to the emergency department with complaints of dyspnea and pleuritic chest pain with transient spotting. On physical examination, she had a non-tender abdomen with a 20-week size uterus. Imaging investigations revealed an acute DVT in her left leg and a huge uterine-derived mass compressing the common iliac veins. Transesophageal echocardiography (TEE) demonstrated an echogenic mass in her right pulmonary artery consistent with thrombosis. The patient was completely cured using thrombolytic therapy and myomectomy, and was well at 1 year after thrombolysis. Conclusions: PE caused by pelvic vein compression is a rare complication of leiomyoma, which should be considered. Thrombolytic therapy associated with myomectomy can be implemented for treating such cases, and TEE can be used for diagnosing suspected high-risk PE. © Am J Case Rep, 2014